{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:59:15Z","timestamp":1740139155160,"version":"3.37.3"},"reference-count":47,"publisher":"American Physiological Society","issue":"4","funder":[{"DOI":"10.13039\/100000050","name":"HHS | NIH | National Heart, Lung, and Blood Institute (NHBLI)","doi-asserted-by":"publisher","award":["HL118539","HL104118","HL122753"],"award-info":[{"award-number":["HL118539","HL104118","HL122753"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014280","name":"Seattle Foundation","doi-asserted-by":"crossref","award":["R-86B41 VB41"],"award-info":[{"award-number":["R-86B41 VB41"]}],"id":[{"id":"10.13039\/100014280","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:p>High-altitude pulmonary edema (HAPE) is a potentially fatal condition affecting high-altitude sojourners. The biggest predictor of HAPE development is a history of prior HAPE. Magnetic resonance imaging (MRI) shows that HAPE-susceptible (with a history of HAPE), but not HAPE-resistant (with a history of repeated ascents without illness) individuals develop greater heterogeneity of regional pulmonary perfusion breathing hypoxic gas (O<jats:sub>2<\/jats:sub>= 12.5%), consistent with uneven hypoxic pulmonary vasoconstriction (HPV). Why HPV is uneven in HAPE-susceptible individuals is unknown but may arise from regionally heterogeneous ventilation resulting in an uneven stimulus to HPV. We tested the hypothesis that ventilation is more heterogeneous in HAPE-susceptible subjects ( n = 6) compared with HAPE-resistant controls ( n = 7). MRI specific ventilation imaging (SVI) was used to measure regional specific ventilation and the relative dispersion (SD\/mean) of SVI used to quantify baseline heterogeneity. Ventilation heterogeneity from conductive and respiratory airways was measured in normoxia and hypoxia (O<jats:sub>2<\/jats:sub>= 12.5%) using multiple-breath washout and heterogeneity quantified from the indexes S<jats:sub>cond<\/jats:sub>and S<jats:sub>acin<\/jats:sub>, respectively. Contrary to our hypothesis, HAPE-susceptible subjects had significantly lower relative dispersion of specific ventilation than the HAPE-resistant controls [susceptible = 1.33 \u00b1 0.67 (SD), resistant = 2.36 \u00b1 0.98, P = 0.05], and S<jats:sub>acin<\/jats:sub>tended to be more uniform (susceptible = 0.085 \u00b1 0.009, resistant = 0.113 \u00b1 0.030, P = 0.07). S<jats:sub>cond<\/jats:sub>was not significantly different between groups (susceptible = 0.019 \u00b1 0.007, resistant = 0.020 \u00b1 0.004, P = 0.67). S<jats:sub>acin<\/jats:sub>and S<jats:sub>cond<\/jats:sub>did not change significantly in hypoxia ( P = 0.56 and 0.19, respectively). In conclusion, ventilation heterogeneity does not change with short-term hypoxia irrespective of HAPE susceptibility, and lesser rather than greater ventilation heterogeneity is observed in HAPE-susceptible subjects. This suggests that the basis for uneven HPV in HAPE involves vascular phenomena.<\/jats:p><jats:p>NEW &amp; NOTEWORTHY Uneven hypoxic pulmonary vasoconstriction (HPV) is thought to incite high-altitude pulmonary edema (HAPE). We evaluated whether greater heterogeneity of ventilation is also a feature of HAPE-susceptible subjects compared with HAPE-resistant subjects. Contrary to our hypothesis, ventilation heterogeneity was less in HAPE-susceptible subjects and unaffected by hypoxia, suggesting a vascular basis for uneven HPV.<\/jats:p>","DOI":"10.1152\/japplphysiol.00494.2016","type":"journal-article","created":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T03:00:32Z","timestamp":1483671632000},"page":"844-852","source":"Crossref","is-referenced-by-count":6,"title":["Susceptibility to high-altitude pulmonary edema is associated with a more uniform distribution of regional specific ventilation"],"prefix":"10.1152","volume":"122","author":[{"given":"Michael D.","family":"Patz","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of Washington, Seattle, Washington;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8885-8671","authenticated-orcid":false,"given":"Rui C.","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Diego, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Darquenne","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Diego, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann R.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Diego, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amran K.","family":"Asadi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Diego, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca J.","family":"Theilmann","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California, San Diego, La Jolla, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Dubowitz","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California, San Diego, La Jolla, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik R.","family":"Swenson","sequence":"additional","affiliation":[{"name":"Medical Service, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. 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